PMHNP Care Across the Lifespan I

Watch the YMH Boston Vignette 5 video and take notes; you will use this video as the basis for your Discussion post.

By Day 3 of Week 1
Based on the YMH Boston Vignette 5 video, post answers to the following questions:

What did the practitioner do well? In what areas can the practitioner improve?
At this point in the clinical interview, do you have any compelling concerns? If so, what are they?
What would be your next question, and why?
Then, address the following. Your answers to these prompts do not have to be tailored to the patient in the YMH Boston video.

Explain why a thorough psychiatric assessment of a child/adolescent is important.
Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent.
Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.
Explain the role parents/guardians play in assessment.
Support your response with at least three peer-reviewed, evidence-based sources and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

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Solution

PMHNP Care Across the Lifespan

What did the practitioner do well?

There were three areas in which the practitioner did well. The first area is in presenting a professional demeanor that included appropriate dressing and good posture. This enhanced the professional interaction as it did not distract the client. The second area is in being attentive to the client. The practitioner gave full attention to the client and was keen to identify the verbal and non-verbal indicators. The third area is in the venue. The counseling occurred in a private room that gave the client some measure of privacy and enabled him to open up (Novalis, Singer & Peele, 2020).

In what areas can the practitioner improve?

The practitioner can improve in the introduction. The session shows that there was no introduction so that the client was not warmed up to the interaction. The lack of introduction can leave the client guarded so that he does not open up and present details (Novalis, Singer & Peele, 2020).

At this point in the clinical interview, do you have any compelling concerns? If so, what are they?

A compelling concern in the clinical interview is the absence of an introduction. The practitioner should have had an introduction with the client. This would present as a casual conversation at the beginning that is intended to create rapport and ease the client into the interview. Going directly into the interview without an introduction keeps the client guarded so that he does not open up and present details (Novalis, Singer & Peele, 2020).

What would be your next question, and why?

The next question is whether the client has opened up to any other person about the break-up and suicidal thoughts. This is important for determining if he is actively seeking a solution. If the client is opening up to others, then he would be more receptive to professional intervention. Conversely, if the client is not opening up, then he would be less receptive to professional intervention (Collarhide & Lemberger-Truelove, 2019).

Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent.

Two rating scales that are appropriate to use during a psychiatric assessment of a child/adolescent are Child PTSD Symptom Scale (CPSS) and Children’s Yale-Brown Obsessive-Compulsive Survey (CY-BOCS). Firstly, CPSS is used to measure PTSD severity among children and adolescents. It can be completed as a self-report or administered by a clinician. Secondly, CY-BOCS is the children’s version of Y-BOCS that is administered by a physician to assess OCD symptoms among children and adolescents, and measure response to treatment (The Child Mind Institute, 2021).

Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.

Two psychiatric treatment options that may work for children and adolescents, and not adults, are acceptance and commitment therapy (ACT) and play therapy. ACT is applied to help in understanding and accepting inner emotions, particularly emotional struggles so that the client moves forward positively. Play therapy uses games, dolls, drawings, blocks, puppets, and toys to help clients recognize, identify, and verbalize feelings (Collarhide & Lemberger-Truelove, 2019).

Explain the role parents/guardians play in assessment.

The parents/guardians provide details about the child/adolescent during the assessment. They have details about the client at home and their information is comprehensive to help with better understanding the client (Collarhide & Lemberger-Truelove, 2019).

References

Collarhide, C. T., & Lemberger-Truelove, M. E. (Eds.) (2019). Theories of School Counseling Delivery for the 21st Century. Oxford University Press.

Novalis, P. N., Singer, V., & Peele, R. (2020). Clinical Manual of Supportive Psychotherapy (2nd ed.). American Psychiatric Association Publishing.

The Child Mind Institute (2021). Child psychiatry rating scales for primary care physicians. https://candapediatricmedicalhomes.wordpress.com/child-psychiatry-rating-scales-for-primary-care-physicians/

YMH Boston. (2013, May 22). Vignette 5 – assessing for depression in a mental health appointment [Video]. YouTube. https://www.youtube.com/watch?v=Gm3FLGxb2ZU

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